Organization
SUE'S SOURDOUGH ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN CRESS (DIRECT OWNER)
(907) 345-1854
Entity
Organization
Contact information
Practice address
14650 PARK HILLS DR, ANCHORAGE, AK 99516-4241
(907) 345-1854
Mailing address
PO BOX 110041, ANCHORAGE, AK 99511-0041
(907) 345-1854
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
100415
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RL3740
—
AK
Enumeration date
04/11/2007
Last updated
08/22/2020
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